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Nurse Practitioner Scope of Practice

Nurse Practitioner Scope of Practice

Sample Answer 

Nurse Practitioner Scope of Practice

Scopes of practice for nurse practitioners define the minimum standards of competency in clinical practice that are expected of a nurse practitioner. They describe the type of patient population a nurse practitioner can serve and the range of services they can offer and bill, such as initiating diagnostic testing and prescribing for patients. More importantly, scopes of practice define the limits of clinical practice for nurse practitioners. Nurse practitioner scopes of practice generally vary across States in accordance with the Nurse Practice Act of each State. In accordance with the recommendations of recent years, more States are continuing to revise the nurse practitioner scopes of practice to grant nurse practitioners full practice authority.

Nurse Practitioner Scope of Practice

Nurse Practitioner Certification

The most important entities for defining the nurse practitioner scopes of practice are the various Nurse Practice Acts enforced through State licensure for certified NPs. Following the completion of a graduate degree such as a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP), the prospective NP must obtain exam-based certification from either the American Academy of Nurse Practitioners Certification Board or the American Nurses Credentialing Center (ANCC) (AANP, 2019). Upon State licensure, they can work in outpatient, acute, and chronic patient care settings.

Nurse Practitioner Scopes of Practice

As experts in primary care and the nursing process, NPs can supervise the activities of nurses in lower cadres and NP students. They can authorize student nurse practitioners to perform particular actions in the clinical area based on the competence and experience of the student and their own competence (Parker & Hill, 2017). In addition, assigning such restricted activities is based on clear conditions for authorization and management of risks that the client experience as a result of the actions of the nurse who is being supervised.

Similarly, NPs can also consult and refer clients to other healthcare providers and professionals. As a healthcare provider, the NP is accountable to the client to initiate referrals when they establish that the client requires the expertise of another provider or the client’s health needs are beyond the range of services they can legally provide (Traczynski & Udalova, 2018). NPs can also receive referrals from other healthcare providers, which they can handle based on their clinical expertise and level of involvement determined by law. Referrals and consultations involving NPs are conducted in collaboration with both clients and other involved professionals.

Furthermore, NPs can make requests for various diagnostic tests. These include laboratory investigations and various forms of imaging such as X-rays, ultrasound examinations, and computed tomography scans (Traczynski & Udalova, 2018). Other tests that NPs can request include echocardiograms and fetal investigations such as amniocentesis and stress tests. The results of requested investigations are documented, managed, and followed up based on the expertise and the extent permitted by law (Maier & Aiken, 2016). However, the evaluation of imaging findings is reserved for respective specialists, such as diagnostic radiologists, with the NP only allowed to initiate required management.

NPs can also conduct advanced patient assessments that match their level of training and experience. Formal learning programs for NPs equip them to conduct advanced assessments such as cognitive evaluation and financial incapability evaluation. These assessments are conducted based on the established procedural guides and the NP’s learning experience.

Finally, the scope of practice of NPs allows them to perform particular advanced procedures in the clinical setting beyond the supervision of young nurses. However, the range of advanced procedures and actions an NP can perform is based on their foundational learning and clinical competence. In certain cases, proof of additional training and professional development is required. Various bodies offering advanced certification, such as the American Academy of Nurse Practitioners Certification Board and the ANCC, can provide certification for these special privileges.

Professional Organizations for Nurse Practitioners

Professional nursing organizations are crucial in the effort to advance the scope of practice of NPs. Three of the most crucial organizations in this pursuit are the American Association of Nurse Practitioners (AANP), the National Council of State Boards of Nursing (NCSBN), and the American Nurses Association (ANA). The NCSBN is a non-profit body that provides a platform for entities that regulate nursing practice to confer and act on issues of significance in nursing practice and the nursing profession. It considers issues of national health interests, such as public health and certification examinations (NCSBN, 2019). ANA is the umbrella organization for all nurses and has membership in virtually all states. Its roles in improving nursing practice include advocacy on work environment issues, lobbying, and professional development. The ANA has been at the forefront of the campaign to advance the practice of Advanced Practice Registered Nurses (APRNs), including NPs, through dialogues and advocacy initiatives targeting the Federal Trade Commission (FTC) (ANA, 2017). FTC is one of the greatest opponents to the advancement of scopes of practice.

However, the organization I would most like to join is the AANP. The mission of the AANP is to empower NPs by improving practice, education, advocacy, and leadership in order to promote quality patient care (AANP, 2019). As a future NP, I believe that the hallmark of quality care is client satisfaction, fostered through building trusting relationships with clients. AANP’s emphasis on the importance of education is therefore in line with this principle since the organization offers professional development resources for enhancing patient care. For instance, AANP emphasizes the need to learn the history of clients and their routines as a means to improve their care. Joining the AANP may be beneficial in a number of ways, including access to free professional development resources such as continuing education materials and courses and scholarships and sponsorship for learning opportunities such as workshops and seminars. AANP will also facilitate my practice through increased access to clinical reference tools and practice groups which indulge in clinical discussion and knowledge sharing (AANP, 2019). AANP membership may, therefore, be beneficial in my future role as an NP.

Liability Concerns

Regardless of the milestones that have been made towards granting APRNs, such as NPs full practice authority, several controversial issues remain. Liability concerns are one of the greatest issues (Brock, Nicholson, & Hooker, 2017). Traditionally, nurses work alongside other professionals as members of a patient care team that a physician leads. In such a patient care model, patient care and clinical decisions are mainly controlled and supervised by the physician, while nurses, including APRNs, play a more passive team player role. However, expanding scopes of practice will see APRNs assume more leadership roles in clinical teams with additional capabilities, such as the ability to make autonomous clinical decisions (Spetz, Skillman, & Andrilla, 2017). Such autonomy has previously been the preserve of clinicians.

In light of the increasing autonomy of APRNs, they will become more liable than they are currently in the event of patient outcomes and safety concerns such as adverse events. As APRNs’ scope of practice continues to resemble that of physicians, liability issues may worsen in the future. Eventually, APRNs may be held to a medical standard of care which may increase the number of claims of malpractice against APRNs (Brock, Nicholson, & Hooker, 2017). This means that additional training is required to enhance the clinical acumen of APRNs. More importantly, work redesign in the healthcare setting is necessary to enhance inter-professional communication and collaboration between APRNs and other disciplines.


AANP. (2019, October 1). AANP Member Benefits. Retrieved from AANP:

AANP. (2019, October 1). Scope of Practice for Nurse Practitioners. Retrieved from AANP:

ANA. (2017, October 1). Advanced Practice Registered Nurses (APRN). Retrieved from American Nurses Association:

Brock, D. M., Nicholson, J. G., & Hooker, R. S. (2017). Physician assistant and nurse practitioner malpractice trends. Medical Care Research and Review, 613-624.

Maier, C. B., & Aiken, L. H. (2016). Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study. European Journal of Public Health, 927-934.

NCSBN. (2019, October 1). The world leader in nursing regulatory knowledge. Retrieved from NCSBN:

Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the united states, canada, australia and hong kong special administrative region (SAR), china. International Journal of Nursing Sciences, 196-204.

Spetz, J., Skillman, S. M., & Andrilla, C. H. (2017). Nurse practitioner autonomy and satisfaction in rural settings. Medical Care Research and Review, 227-235.

Traczynski , J., & Udalova, V. (2018). Nurse practitioner independence, health care utilization, and health outcomes. Journal of health economics, 90-109.


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Nurse Practitioner Scope of Practice

Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system.

Nurse Practitioner Scope of Practice

Nurse Practitioner Scope of Practice

For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system. Includes the following:

  • A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope.
  • A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice?
  • A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse?

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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